India’s first multi-centre randomised controlled trial on the use of Tocilizumab in COVID (COVINTOC – Covid – India – Tocilizumab) has demonstrated that an anti-inflammatory treatment, Tocilizumab (TCZ), reduces the risk of death among patients with severe COVID-19.

The results of the trial were published in ‘The Lancet Respiratory Medicine’. Explaining the outcome of India’s largest study on Tocilizumab which was conducted from May to October 2020, Dr Arvinder Soin National Lead investigator and Chairman, Medanta Liver Institute said that this was the first Phase 3 study to demonstrate that while routine use of TCZ on all hospitalised COVID patients was not warranted, TCZ improved survival among patients with severe COVID-19. 

A total of 180 patients were recruited, 90 of whom received Tocilizumab (TCZ) and standard care, whereas the other 90 received only standard care. Steroids and Remdesivir once allowed by the MoHFW, were administered to patients in both arms.

While there was no difference in mortality and need for ventilation among the two groups of patients when moderate and severe categories of patients were considered together, a subgroup analysis of the severe patients in the two groups showed lower mortality (8/50; 16 per cent) among those who received Tocilizumab compared to those who did not (14/41; 34 per cent) at 28 days.

Elaborating on the use of TCZ, Dr Soin said, incidentally, in the last month, two major studies - the RECOVERY Trial from the UK and the REMAP-CAP study – have revealed similar findings, that TCZ reduces mortality among patients with severe COVID. However, unlike our study, these are not yet published in peer-reviewed journals. 

Congratulating the multi-institutional Indian research team, Dr Naresh Trehan, Managing Trustee, Medanta Institute of Education and Research, and Chairman & Managing Director, Medanta, said, “This research is instrumental in giving the medical fraternity clarity on when to use TCZ in COVID.”